Journal Watch - 2016

Why Do People Stop Doing Home HD?

Among 2,840 people who started home HD between 2007 and 2009, nearly one in four stopped within a year, while 1-year mortality was 7.6%. The risks of stopping home HD were higher among those with diabetes, and substance use (alcohol, tobacco, drugs). Those who were listed for transplant or lived in rural areas were less likely to stop home HD.

Nanomembranes for Miniature HD

Dialyzors with membranes that are more permeable could be much smaller—in fact, small enough for wearable dialysis. Ultra-thin silicon may be a candidate, and a prototype miniature membrane is predicted to clear toxins at “near-ideal levels.”

PD After Loss of Residual Kidney Failure

Once residual kidney function is gone, it is vital to address fluid volume, finds a new study that followed 183 people. During the 10.5-36 months of follow up, 65% either switched to HD or died. Their inflammation rates (measured by C-reactive protein levels) were high, as were their extracellular water levels (measured by bioelectrical impedance analysis).

Anxiety, Depression, and PD Technique Survival

Among 201 PD patients, those whose testing revealed higher levels of anxiety were more likely to die or to switch to another option than those with lower levels. Other predictors included needing help from a care partner, comorbidities, and low albumin levels.

Using Plant-Protectant Resveratrol to Preserve the Peritoneum

Resveratrol is a phenol found in the skins of grapes and some berries that can help keep blood vessels from growing to support tumors. A new prospective, randomized, controlled, double blind study looked at its use to keep blood vessels from growing in the peritoneum, which can cause PD technique failure. Participants (n=72) were given 12 weeks of low- or high-dose resveratrol or placebo. Those who received a high dose of resveratrol had significantly better ultrafiltration.

CT Scans Can Help Find Encapsulating Peritoneal Sclerosis

Finding EPS early can make treatment of this devastating problem more successful. This study had experienced radiologists look at CT scan results from 18 people with confirmed EPS and 26 matched controls with it. The radiologists were blinded to who had the disorder. Peritoneal thickening, calcification, and other findings were more common in the EPS group. Some radiologists were better than others at detecting the differences that suggested EPS.